Private Practice The Heights Hospital. Houston, Texas Dallas, Texas
The posterior zygoma implant is indicated when there is a major atrophy in the posterior maxilla and wide maxillary sinus. The implant positioning is based on the prosthesis, and the ideal position would be lateral to the alveolar ridge. A surgical guide is utilized, the soft tissues are reflected exposing the zygoma with a retractor (Branemark). A 703 bur is utilized to create a triangular perforation in the maxillary sinus wall right at the zygoma body junction (Stella); the base of the zygoma body is identified and the surgeon selects to go extra-sinus or intra-sinus approach. After progressive drilling, the implant is mounted on a hand piece inserting the fixture in the zygoma, the implant is in a 45 to 60 degrees inclination. The implants should be covered with bone grafting, collagen membranes and the lateral fat pad. The most common complications in the past were oro-sinus fistulas, sinusitis and exposed zygoma implants. The closure is performed with Vicryl 3-0, an incision at the periosteal layer allows a non-tension closure. At the end of the surgery the anchorage is obtained in the zygoma and bone graft are used to create bone laterally and the alveolus site.
Learning Objectives:
At the conclusion of this presentation, participants should be able to:
Demonstrate use of zygoma implants.
Indicate zygoma implants for severe maxillary atrophy and teeth in a day surgical-prosthodontics.
Calculate how to reduce treatment costs dramatically.